M16.9 — Osteoarthritis of hip, unspecified
Is M16.9 billable?
Yes, but M16.9 is an unspecified code. M16.9 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, M16.9 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting M16.9 — the more specific alternatives are listed below.
More specific alternatives
- M16.0Bilateral primary osteoarthritis of hip
- M16.1Unilateral primary osteoarthritis of hipnot billable
- M16.2Bilateral osteoarthritis resulting from hip dysplasia
- M16.3Unilateral osteoarthritis resulting from hip dysplasianot billable
- M16.4Bilateral post-traumatic osteoarthritis of hip
- M16.5Unilateral post-traumatic osteoarthritis of hipnot billable
- M16.6Other bilateral secondary osteoarthritis of hip
- M16.7Other unilateral secondary osteoarthritis of hip
M16.9 at a glance
| Code | M16.9 |
|---|---|
| Description | Osteoarthritis of hip, unspecified |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does M16.9 group to?
M16.9 sits in MDC 08 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 553Bone Diseases and Arthropathies with MCCmedical
- 554Bone Diseases and Arthropathies without MCCmedical
How is M16.9 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to M16.9. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Morbus › coxae senilis
- Osteoarthritis › hip
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M16.9, but a patient may have both at the same time. When documentation supports it, M16.9 and the excluded code may both be reported.
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Excludes2 — not included here — inherited from M15-M19
The conditions below are not part of M16.9, but a patient may have both at the same time. When documentation supports it, M16.9 and the excluded code may both be reported.
- osteoarthritis of spine (M47.-)
How long has M16.9 existed?
M16.9 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
Which conditions are coded to M16.9?
What other codes are in the M16 family? (8)
- M16.0Bilateral primary osteoarthritis of hip
- M16.1Unilateral primary osteoarthritis of hipnot billable
- M16.2Bilateral osteoarthritis resulting from hip dysplasia
- M16.3Unilateral osteoarthritis resulting from hip dysplasianot billable
- M16.4Bilateral post-traumatic osteoarthritis of hip
- M16.5Unilateral post-traumatic osteoarthritis of hipnot billable
- M16.6Other bilateral secondary osteoarthritis of hip
- M16.7Other unilateral secondary osteoarthritis of hip